Papers by Deborshi Sharma
JSLS, 2012
Laparoscopic cystogastrostomy is an established procedure for the drainage of pancreatic pseudocy... more Laparoscopic cystogastrostomy is an established procedure for the drainage of pancreatic pseudocysts. Cysts are mainly present in the lesser sac (retro-gastric), which is completely amenable to cystogastrostomy. We discuss the problems faced and simple solutions to the problems in managing a huge pancreatic pseudocyst of 22 cm×18 cm in a young boy 18 y of age.
Randomized single blind trial to compare the short term post-operative outcome and cost analysis of laparoscopic versus ultrasound guided transversus abdominis plane block in patients undergoing bariatric surgery
Surgical Endoscopy
Extensive systemic and cutaneous metastasis â Extremely rarepresentation of breast carcinoma
Cutaneous metastases from systemic malignancy are relatively uncommon. Breast carcinoma is one of... more Cutaneous metastases from systemic malignancy are relatively uncommon. Breast carcinoma is one of the most common cancer in women which metastasize to skin. Skin metastasis found in 0.7% to 10.4% of all patient with systemic malignancy. Here we report a 36-year-old lady with advanced primary ductal carcinoma of right breast ( T4N1M1 ) stage 4 disease who presented us with 1 year history of right breast lump, progress from small 2 cm nodule in right breast, remain static for another 9 months and then suddenly progress to recent size of 15 × 15 cm with development of multiple skin swelling in abdomen, back, upper arm, and right thigh region simultaneously. These skin nodules are clinically mimicking lipoma. There is multiple mobile lump in left breast also mimicking fibroadenoma which are increasing in size and number in last 3 months. These swelling in skin and opposite breast are turn out to be metastatic nodules after histopathology report. After radiological examination metastatic...
Extended-View Totally Extraperitoneal Approach (eTEP) for Inguinal Hernia Repair
Recent Concepts in Minimal Access Surgery, 2022
Role of ICG Fluoroscence Imaging in Laparoscopic Bowel Anastomosis
Springer Singapore eBooks, 2022
International Surgery Journal, Feb 28, 2022
Scrotal involvement is extremely rare complication of acute necrotising pancreatitis. It presents... more Scrotal involvement is extremely rare complication of acute necrotising pancreatitis. It presents as scrotal swelling and skin color change, which mimics the presentations of testicular torsion, epididymitis, and testicular tumor. Early diagnosis can significantly reduce the associated mortality both with necrotising pancreatitis and Fournier gangrene. Thorough clinical examination along with abdominopelvic Computed Tomography provides a useful means of diagnosing this complication. Here, we are presenting a case of acute necrotising pancreatitis with collection in left pararenal space tracking all the way to reach the left inguinal canal till the root of scrotum, being managed successfully after early diagnosis with early debridement and application of vacuum assisted drainage.
Minimizing Pain in Laparoscopic Hernia Surgery
Springer Singapore eBooks, 2022
International Surgery Journal, 2022
Background: Midline ventral hernia is a common complication of abdominal surgeries. Laparoscopic ... more Background: Midline ventral hernia is a common complication of abdominal surgeries. Laparoscopic mesh hernioplasty is novel method of hernia repair but has many complications. Venous thromboembolic complications are one of them.Methods: A prospective observational study in patients with midline ventral hernia was carried out. Based on the size of defect patients were divided into two groups (consisting 60 patients each). Group A with hernia defect size of less than 6cm and group B with more than 6 cm. Group A patients underwent intraperitoneal onlay mesh plus repair and group B patients underwent endoscopic components separation technique with intraperitoneal onlay mesh repair. Each patient was followed up at day 5 and day 30 postoperatively and Well’s score was calculated. The patients with ‘Likely’ score were taken for Doppler ultrasonography. The patients with ‘Unlikely’ score were further evaluated with D-Dimer study. Patients with raised value of D-Dimer were taken for Doppler ...
Arquivos Brasileiros de Cirurgia Digestiva : ABCD, 2016
A middle aged women with history of old inferior wall myocardial infarction and BMI 42 underwent ... more A middle aged women with history of old inferior wall myocardial infarction and BMI 42 underwent LSG. She had an eventless intraoperative period and was used five fires of green and blue staplers to cover the length of the sleeve. After, checking for any leak using the air leak test was done. At that time a moderate alarm was sounded by the peri-operative physicians that the nasogastric (NG) tube was struck somewhere as it was not coming out. Immediately by focusing on the remnant gastric sleeve a dimple was noticed around the mid of the sleeve every time the anaesthetist was trying to pull the tube out. The extracted gastric greater specimen was examined by opening the greater curve to find the severed distal end of the NG tube firmly stapled (Figure 1). Knowing that the NG tube has been stapled to the sleeve (Figure 2), the 36 Fr gastric calibration tube was reinserted into the sleeve, the staples of the attached area of the NG tube to the sleeve were cut and opened using an ultra...
Synchronous malignancies: A tale of two different tumors
Indian Journal of Pathology and Microbiology, 2020
1. Cossu A, Massarelli G, Manetto V, Viale G, Tanda F, Bosincu L, et al. Rhabdoid tumours of the ... more 1. Cossu A, Massarelli G, Manetto V, Viale G, Tanda F, Bosincu L, et al. Rhabdoid tumours of the central nervous system. Virchows Arch A Pathol Anat Histopathol 1993;422:81‐5. 2. Tunc B, Filik L, Tezer‐Filik I, Sahin B. Brain metastasis of hepatocellular carcinoma: A case report and review of the literature. World J Gastroenterol 2004;10:1688‐9. 3. Daga D, Dana R, Kothari N. Hepatocellular carcinoma ‐ An unusual metastatic presentation on the chest wall. Clin Exp Hepatol 2016;1:133‐5. 4. Chang L, Chen YL, Kao MC. Intracranial metastasis of hepatocellular carcinoma: Review of 45 cases. Surg Neurol 2004;62:172‐7. 5. Perry A, Scheithauer BW, Stafford SL, Abell‐Aleff PC, Meyer FB. “Rhabdoid” meningioma: An aggressive variant. Am J Surg Pathol 1998;22:1482‐90. How to cite this article: Kumar H, Kinra P, Malik A. Metastatic hepatocellular carcinoma in brain masquerading as rhabdoid CNS tumour – A case report. Indian J Pathol Microbiol 2020;63:145-7.
Indian Journal of Surgery, 2017
Short bowel syndrome (SBS), one of the commonest types of intestinal failure, usually secondary t... more Short bowel syndrome (SBS), one of the commonest types of intestinal failure, usually secondary to extensive bowel resection, traditionally has been associated with a high mortality rate and hence a big challenge for the treating surgeons. It requires comprehensive clinical care to minimise the morbidities and mortality associated with the condition. We report a retrospective review of a series of seven patients with SBS, who presented at our surgical emergency within a period of 1 year and their outcome so as to encourage others in managing such a challenge with more positive mindsets. A retrospective analysis of seven patients with SBS admitted from January 2014 to January 2015 with a follow-up of 1 year has been done in terms of their demographic characteristics, underlying pathology and clinical outcome. A rising incidence of SBS in the younger age group (71.4%) has been observed in this analysis. Majority of patients (57.1%) had mesenteric ischemia as the underlying cause followed by each case of small bowel volvulus, internal herniation and blunt trauma abdomen. A discharge rate of 71.4% and mortality rate of 28.5% were observed. With this analysis, we believe that SBS is no more an uncommon condition. A structured clinical approach, timely surgical intervention and multidisciplinary postoperative management are essential for managing such frail patients to achieve best possible results. This will encourage others in managing such a critically challenged condition with a more positive approach and thus beneficial for both the patients and the treating surgeon.
The Internet Journal of Surgery, 2008
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo), 2016
Non-traumatic extrahepatic biliary perforation: a diagnostic uncertainty and management dilemma
Hellenic Journal of Surgery, 2016
Spontaneous or non-traumatic perforation involving the wall of the extrahepatic or intrahepatic b... more Spontaneous or non-traumatic perforation involving the wall of the extrahepatic or intrahepatic biliary tree is a rare entity leading to difficulty and delay in preoperative diagnosis and resulting in 30% to 50% mortality in spite of adequate surgical therapy and postoperative intensive care. Multiple factors are involved in its pathogenesis in both adults and infants. Patients can present with acute or insidious onset. Diagnostic modalities include ultrasound, abdominal CECT and radionuclide hepatobiliary scan. However, in the presence of clinical features of generalized peritonitis, surgery should not be unduly delayed due to non-availability of these diagnostic tools. A high index of suspicion and an early surgical intervention are the mainstays of therapy. Surgical management remains controversial. The nature and extent of surgery, both by open exploration and laparoscopy, should be tailored according to the patient’s general condition, the severity of the peritonitis, and intraoperative and cholangiographic findings.
Chapter-084 Non-Traumatic Splenectomy
Textbook of Surgical Gastroenterology (2 Volumes), 2016
Pseudo-recurrence after laparoscopic inguinal hernia repair
Hellenic Journal of Surgery, 2015
Aim-BackgroundPseudo-recurrence after laparoscopic hernia repair, though known, is poorly underst... more Aim-BackgroundPseudo-recurrence after laparoscopic hernia repair, though known, is poorly understood. Common causes of pseudo-recurrence are pneumoscrotum, haematoma, seroma, cord thickening and persistent cough impulse.AimTo analyze the incidence of pseudo-recurrence and its impact on morbidity after laparoscopic inguinal hernia repair.MethodsAll laparoscopic inguinal hernia repair cases performed by a single surgical unit over a period of five years from April 2007 till March 2012 were retrospectively analyzed.ResultsAmong 243 operated laparoscopic inguinal hernia repairs (TEP and TAPP) included in the study, twenty (8.26%) cases displayed a pneumoscrotum, eighteen (7.43%) a haematoma, twenty-four (9.98%) a seroma, eight (3.29%) cord thickening, and six (2.46%) persistent cough impulse. All patients were managed conservatively with the exception of one case of seroma which had to be aspirated.ConclusionPseudo-recurrence following laparoscopic inguinal hernia repair, though common, has no significant impact on morbidity. Recognition of the problem is important to continue conservative management and avoid intervention.
The Internet Journal of Urology, 2007
Although tuberculosis of the penis is rarely reported even in endemic countries like India, it is... more Although tuberculosis of the penis is rarely reported even in endemic countries like India, it is wise to exclude it in cases of suspicious penile ulcers by relevant investigations after a thorough history taking. Prompt administration of SCC can even lead to complete healing of the lesion without leaving behind any sequelae.
Indian Journal of Surgery, 2013
Treatment of metastatic liver disease is at the crossroads of an evolutionary transformation with... more Treatment of metastatic liver disease is at the crossroads of an evolutionary transformation with more and more reports reiterating the benefits of resectional therapy in various cancers. A quest for application of laparoscopic approaches to the management of liver metastasis has arisen due to the projected benefits of less morbidity, early recovery, and equivalent oncological outcome in selected malignancies. However, the diverse and heterogenous data on indications, operative technique, and outcome evaluation make a comparative analysis of these studies difficult. This review is an appraisal of technique and outcome of minimally invasive liver resection as reported in the current literature with special reference to treatment of metastatic colorectal cancers.
Indian Journal of Surgery, 2012
The aims of this paper were to compare the predictive validity of three pressure ulcer (PU) risk ... more The aims of this paper were to compare the predictive validity of three pressure ulcer (PU) risk scales-the Norton scale, the Braden scale, and the Waterlow scale-and to choose the most appropriate calculator for predicting PU risk in surgical wards of India. This is an observational prospective cohort study in a tertiary educational hospital in New Delhi among 100 surgical ward patients from April to July 2011. The main outcomes measured included sensitivity, specificity, positive predictive value (PVP) and negative predictive value (PVN), and the area under the curve of the receiver operating characteristic (ROC) curve of the three PU risk assessment scales. Based on the cutoff points found most appropriate in this study, the sensitivity, specificity, PVP, and PVN were as follows: the Norton scale (cutoff, 16) had the values of 95.6, 93.5, 44.8, and 98.6, respectively; the Braden scale (cutoff, 17) had values of 100, 89.6, 42.5, and 100, respectively; and the Waterlow scale (cutoff, 11) had 91.3, 84.4, 38.8, and 97, respectively. According to the ROC curve, the Norton scale is the most appropriate tool. Factors such as physical condition, activity, mobility, body mass index (BMI), nutrition, friction, and shear are extremely significant in determining risk of PU development (p<0.0001). The Norton scale is most effective in predicting PU risk in Indian surgical wards. BMI, mobility, activity, nutrition, friction, and shear are the most significant factors in Indian surgical ward settings with necessity for future comparison with established scales.
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 2009
Hydatid disease mostly affects the liver with Echinococcus granulosus being the most common organ... more Hydatid disease mostly affects the liver with Echinococcus granulosus being the most common organism. Surgery remains the gold standard in terms of therapy for patients with echinococcosis of the liver despite significant economic costs, advances in medical treatment, and interventional radiology. Laparoscopy, as a minimally invasive surgery, has well-known clinical advantages over traditional surgery. Several reports have confirmed the benefit of a laparoscopic approach to liver hydatid disease. We describe our technique and analyze numerous reports of laparoscopic hydatid liver surgery along with our results.
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Papers by Deborshi Sharma